AccountId: 011433970860
ContactId: f19ba7c1-5276-4a0f-a581-49d48c08d1c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200070 ms
Total Talk Time (AGENT): 96925 ms
Total Talk Time (CUSTOMER): 46057 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/f19ba7c1-5276-4a0f-a581-49d48c08d1c4_20250130T16:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from Baptist Memorial Hospital. I'm looking for a claim denial clarification. How are you doing today?
[AGENT][POSITIVE] I'm doing well, thank you. I'm sorry, can I have you repeat your first name?
[CUSTOMER][NEUTRAL] I'm [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you [PII], can I have a callback number for you just in case we get disconnected please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure, it is [PII].
[AGENT][NEUTRAL] Thank you [PII], and do you have the member's policy or a certificate number or member ID?
[CUSTOMER][NEUTRAL] Yeah, I do. And the member's ID is
[CUSTOMER][NEUTRAL] 02274763.
[AGENT][NEUTRAL] Thank you and you said it was for a claim inquiry, uh, claim denial reason? OK, I'll be happy to help you with that. Just give me one moment please, [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And may I please have you verify the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that. Now did you have a claim number, [PII], or do you have a data service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, one moment, let me check the claim number.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, it is 3258078.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that looks like it was for data service [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the claim amount was $584 is that correct?
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][NEUTRAL] OK, just give me one moment to search some information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It looks like our coverage is term, but I'm verifying that information now, so just bear with me for one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like the policy was termed, um, so the date of service, uh, of [PII] was denied due to the uh policy did term. Now their effective date was [PII].
[AGENT][NEUTRAL] And the coverage term.
[AGENT][NEUTRAL] On [PII].
[AGENT][NEUTRAL] And I show no active coverage after [PII].
[CUSTOMER][NEUTRAL] Thank you for all this information. And can I get the reference number for our conversation, please?
[AGENT][NEUTRAL] Certainly, [PII], the call reference number you would use my name in today's date. My first name is [PII] My last initial [PII].
[AGENT][NEUTRAL] Did you have any other questions?
[CUSTOMER][POSITIVE] Yeah, that's all I wanted to know. Thank you for your assistance. Have a lovely day.
[AGENT][POSITIVE] You too, [PII] thank you for calling AP I hope you have a great rest of your day as well. Bye bye.
[CUSTOMER][NEUTRAL] OK.